A soldier relates how a detainee said he was hit on the head with large object, which could be the butt of a rifle, but he did not see because he had a hood on. Detainee had a bump on his head.
SWORN STATEMENT
For use of this form, see AR 190-45; the proponent agency is ODCSOPS LOCATION DATE TIME FILE NUMBER
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, WANT TO MAKE THE FOLLOWING STATEMENT UNDER OATH:
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EXHIBIT INITIALS OF PERSON MAKING STATEMENT
PAGE 1 OF PAGES
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ADDITIONAL PAGES MUST CONTAIN THE HEADING 'STATEMENT OFDTAKEN ATDDATEDDCONTINUED." THE BOTTOM OF EACH ADDITIONAL PAGE MUST BEAR THE INITIALS OF THE PERSON MAKING THE STATEMENT AND BE INITIALED
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STATEMENT WILL BE CONCLUDED ON THE REVERSE SIDE OF ANOTHER COPY OF THIS FORM. •
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DA FORM 2823, JUL 72HSUPERSEDES DA FORM 2823, 1 JAN 68, WHICH WILL BE USED.
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DOD-043626
TEMENT (Continued)
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AFFIDAVIT
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HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT WHICH BEGINS ON PAGE 1 AND ENDS ON PAGE o2 . I FULLY UNDERSTAND THE CONTENTS OF THE ENTIRE STATEMENT MADE
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CONTAINING THE STATEMENT. I HAVE MADE THIS STATEMENT FREELY WITHOUT HOPE OF BENEFIT OR REWARD, WITHOUT THREAT OF PUNISHMENT, AND WITHOUT COERCION. UNLAWFUL INF
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Subscribed and sworn to before me. a oerson authorizedivA2 administer oaths, this fg day of real, at KA NO A hittDliytruf SM,J
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ORGANIZATION OR ADDRESS
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ORGANIZATION OR ADDRESS (Authority To Administer Oaths)
INITIALS OF PERSON TEMENT
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DOD-043627